Chullora Electricity Move In Form

I.D
Personal Identification Type*
Authentication Number*
Date Of Birth Day/Month/Year*
xx/xx/xxxx
Upload a File
Please Take Photo Of Your ID (If screen is black press the turn camera around button top right corner) Cancelof

Life Support
Do you or anyone who will be living with you at this premises require life support equipment?

My Products*

Same Business Day Energisation If Form Received Before 2pm Or The Following Business Day If After 2pm (Not Including Sat & Sun)$103.34AUD

Move In Meter Reading Fee$14.43AUD

Subtotal $0.00AUDTax $0.00AUDTotal $0.00AUD

Payment Method
Credit	Express

Debit Arrangements
Payment Method
Please choose a method of payment:
Type*
Bank Code / BSB*
Name On Account*
Account Number*
First 4 digits *
The rest of the digits*
Expiry Date*
dd/yy
Name On Account*
Payments will appear on your statement as UTILITY BILL

I / We authorise Ezidebit Pty Ltd ACN 096 902 813 (User ID No 165969) to debit my/our account at the Financial Institution identified above through the Bulk Electronic Clearing System (BECS) in accordance with the Debit Arrangement stated above and this Direct Debit Request and as per the Ezidebit DDR Service Agreement (Ver 1.12) provided.
Terms & Conditions
I Agree With The Above Terms & Conditions
Hardship Policy
AER Factsheet
Exempt Customer Factsheet
Feedback
Did you know that this is the only building that offers prepaid and postpaid utility solutions?
Would you like to find out how prepayment would benefit you?
How was your sign up experience?
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Account Type